FREE IMMUNIZATION MATERIALS ORDER FORM
Please indicate the quantity you would like of each item, and in which language in the form below.

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Vaccine schedules (easily removable stickers) for newborns up to 16 years of age. (Size 6” x 4”), ENGLISH. (Indicate quantity requested)
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Vaccine schedules (easily removable stickers) for newborns up to 16 years of age. (Size 6” x 4”), SPANISH. (Indicate quantity requested)
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Vaccine schedules (easily removable stickers) for adolescents. (Size 6” x 4”), ENGLISH (Indicate quantity requested)
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Vaccine schedules (easily removable stickers) for adolescents. (Size 6” x 4”), SPANISH (Indicate quantity requested)
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HPV Vaccine fact card. Dual sided ENG/SPA combined card. (Size 4” x 6”). (Indicate quantity requested)
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Adult immunization checklist tip cards for patients to use and discuss with their provider- Diabetes/Heart Disease. Dual sided ENG/SPA. (Indicate quantity requested)
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Adult immunization checklist tip cards for patients to use and discuss with their provider.- HIV/AIDS. Dual sided ENG/SPA. (Indicate quantity requested)
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Adult immunization checklist tip cards for patients to use and discuss with their provider. - Liver/Kidney Disease. Dual sided ENG/SPA. (Indicate quantity requested)
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Adult immunization checklist tip cards for patients to use and discuss with their provider. - Lung Disease/Asthma. Dual sided ENG/SPA. (Indicate quantity requested)
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Adult immunization checklist tip cards for patients to use and discuss with their provider.- Pregnant. Dual sided ENG/SPA. (Indicate quantity requested)
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Infant Brochures. Tri-fold brochure describing the importance of childhood immunizations. Also includes a copy of the infant immunization schedule. In ENGLISH. (Indicate quantity requested)
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Infant Brochures. Tri-fold brochure describing the importance of childhood immunizations. Also includes a copy of the infant immunization schedule. In SPANISH. (Indicate quantity requested)
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Teen Brochures. Tri-fold brochure describing the importance of adolescent immunizations. Also includes a copy of the teen immunization schedule. In ENGLISH. (Indicate quantity requested)
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Teen Brochures. Tri-fold brochure describing the importance of adolescent immunizations. Also includes a copy of the teen immunization schedule. In SPANISH. (Indicate quantity requested)
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Adult Brochures. Tri-fold brochure describing the importance of adult vaccinations. In ENGLISH. (Indicate quantity requested)
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